Utilization of take-home ration and complementary feeding practices among women and young children in tribal Jharkhand: a mixed-methods study

Abstract

Background: Take-home ration (THR) under the Integrated Child Development Services (ICDS) is a key intervention to address nutritional gaps among pregnant women, lactating mothers, and young children. However, evidence suggests that program effectiveness is often constrained by gaps in utilization at the household level, particularly in tribal settings.

Methods: A cross-sectional mixed-methods study was conducted between January and February 2024 in the Kolhan division of Jharkhand. A total of 146 respondents, including pregnant women, lactating mothers, and Anganwadi Workers, were interviewed using structured questionnaires. Additionally, 12 focus group discussions (FGDs) with 8-12 participants each were conducted. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed thematically.

Results: While THR distribution was reported to be regular, significant gaps were observed in its utilization. Awareness regarding recommended quantity and preparation methods was limited among beneficiaries. THR was commonly shared among household members, reducing its consumption by intended beneficiaries. Complementary feeding practices were suboptimal, with most children being fed from the family pot rather than receiving age-appropriate semi-solid foods. Increasing reliance on packaged foods for children was also reported. Qualitative findings highlighted behavioural, cultural, and practical barriers influencing these practices.

Conclusions: Optimal utilization of THR remains limited despite adequate program delivery. Addressing behavioural and knowledge-related barriers through strengthened counselling and community engagement is essential for improving nutritional outcomes.